Category Archives: Strategy

Today in one of my mentoring sessions we were looking at the use of Artificial Intelligence in the pharma industry. This in itself is a fascinating area to look at but equally fascinating was the discussion the topic generated – namely the changing dynamics of the healthcare industry and the pharmaceutical industry’s continued snail pace of change.

As we looked at some of the new players entering the market, such as AI startups like BenevolentAi or the big players like Google and Apple, we discussed how pharma is starting to miss increasingly large value opportunities in healthcare, which tech companies are seizing. Whilst currently much of the pharma industry still remains clearly in the domain of the pharma companies that may change in the future as the industry fails to adapt to changes being driven by technology.

Looking at AI & clinical trials for example – currently clinical trials are very clearly the domain for pharma because of the huge financial investments required but also because of the need for highly skilled and experienced people to work in this area. However as AI makes inroads, for example in molecule identification, what’s not to say that non-pharma companies might look at this area and bring in their technology expertise and just hire / poach the expertise they need to run the trials … or indeed just outsource to the CRO?

This article also gives the nice example that technology will increasingly play an important role in treatment and if tech companies find that the pharma industry is the bottle neck to their products what’s to prevent them just buying their own way in to the industry? Once this happens pharma could potentially face major issues as all of sudden their direct competition no longer comes from another slow, cumbersome pharma company but rather an agile, dynamic and fast moving tech company.

And this leads on to another factor that is also hindering the industry namely how cumbersome and slow the internal systems and structures are. Even when a pharma decides to partner with a start up (which is happening but IMHO not as much as it should be) often the clash between the two cultures proves a major obstacle to the success of the partnership. While a startup will expect to move quickly – and may need to move quickly due to limited funds – they then find themselves with a partner who may expect things to take years (by which time the startup has run out of funds / has lost key people / etc.).

Many people in pharma argue that due to regulations this is a totally different market and it is the regulatory environment that hampers speed I would push back on this. Time and time again regulatory constraints is bandied around as an excuse when it should not be. The length of time it takes for a pharma company to draft and sign off a contract or agreement with a startup for example has very little to do with the regulatory environment but rather with the internal systems and staff.

Another cultural aspect that differs between pharma and tech companies – and again which is only partially linked to the regulatory environment – is the right to fail. Traditionally pharma, like many other industries, will only launch or release something when it is perfect, which contrasts with the tech industry which focuses more on agility and adaption. Many tech companies will launch something as a beta version – so not final – but will then adapt it based on feedback and data. Whilst this approach may not be appropriate for the actual pharma products there are many other parts of the industry that would benefit from this approach.

So will we be losing our jobs to the likes of Google and Apple? Probably not in the near future but if pharma companies continue to only adapt at a snails pace it will become less of a philosophical debate and will move closer to reality. And what is certain is that as pharma tries to deal with increasing costs and prices pressures if they do not start to look at the full value picture of the healthcare industry they will lose out on potential new revenue and value sources – and there are plenty of non-pharma companies lining up to grab this value.

My last post was all about the value of respecting your customers, particularly if you are an airline, and was based upon my terrible experience with Turkish Airlines. To complete that article I should add that my experience with Turkish Airlines continued to be bad including during the flight with some of the most inedible food I’ve ever attempted to eat, old airplanes with seats that did not recline properly and grumpy crew. My holiday itself however was awesome 🙂

As I looked back at this article though I thought it also worthwhile to add my opinion on respecting your customers in the pharmaceutical industry. For too long this industry has been very self-centered and not particularly focused on customers, especially patients (who I also include as customers). Of course the industry is “plagued” by regulation which has made it harder to be as customer centric per se as many other industries. We all know by now that the end of the blockbuster era and the patent cliff ushered in huge change and a shift in thinking for the industry but we are still not where we should be.

So why are we still not as customer centric as we could be? Regulation is often one of the first reasons bandied about for this … “we can’t talk directly to our patients” or “we can’t do that because of regulatory restrictions”. Very often this is however just an excuse. We can still be customer centric and comply with regulations. For starters many patients do not want to hear promotional messages about pharma products anyway so even if we could bombard them with product branded marketing this would still be pharma and not customer centric.

Even where we can do promotion for it to be most effective it should be targeted and try to provide some value to the customer. What is it that a physician needs or wants to hear about? If we develop content – promotional or not – with the customer in mind then we generally see far greater results than if we just stubbornly try to force our message down their throats.

Coming back to the regulatory side of things though I do also believe that it is time regulators also become more customer centric, particularly towards patients. Whist I do not support a US style DTC promotion I also believe that the pharma industry sits on a large swathe of data that would be highly valuable and beneficial to patients, and HCPs. Much of this data is never made available to patients – in part because of compliance but also in part because of the “fear” of regulation and legal action. Counter this with the number of misinformation that patients now have access to online I think there needs to be a change in thinking in how we communicate and share information online. I firmly believe that as an industry (both pharma & regulators) we have a duty of care to make sure that patients have access to accurate, reliable information. We need to drown out the misinformation, and make sure that the correct information is coming in at the top of Google searches, and not hidden away a few pages in.

A second issue is that whilst many patients may never want to know the data, or indeed even understand it, there is a growing number of active and educated patients that do want more information. The informed patient wants to have the data so that they can make their own decisions concerning their healthcare. The days when we as patients blindly trusted what our doctors told us are diminishing. As a patient who has experienced misinformation coming from a specialist, in my case an endocrinologist who told me that the symptoms form my un-managed Hashimoto’s were all in my head, I firmly believe in the movement of the informed patient and the need for patients to be more active in their healthcare. Had I relied on that endocrinologist, and not actively sought my own answers, I doubt I would be here now writing this post as I would probably have either been too depressed or died of heart complications due to over-medication in an attempt to reduce my symptoms.

I think it is high time that all those involved in the healthcare system start to respect patients as decision makers and work together to support the informed patient. How can we make all that data that pharma sits on, that may have no commercial value to the organisation btw, available in a digestible and understandable format for patients. Pharma often has the money and resources to turn the data into content and disseminate it but may not be allowed to – or may not have the incentive to. Much of that data may also have a public health benefit so one could also argue that pharma should not shoulder the burden of dissemination alone. Pharma companies at the end of the day are businesses and if they are not profitable they will go under and that also does not benefit patients.

There are many more questions but there also numerous answers. For starters pharma can start to work more closely with patient associations. Why is it that for many pharma companies the patient advocacy department, if there even is one, is only made up of one or two people?! Whilst we have huge brand teams focused on marketing to HCPs the number of headcount that is focused on patients is tiny by comparison. Pharma really needs to start ramping up in this area.

In turn though regulators may also need to re-assess that pharma patient partnership model. Not all diseases have a patient association but there may be online groups and individual patient experts. How was can facilitate partnerships here for the benefit of all parties? How can we all work together to find a model that supports patients, is compliant but also does not bankrupt pharma? I think the answer lies in the question … we need to all work together! We need to start talking more to patients, and include regulators in those discussions. We need to put patients firmly in the center of the equation, along with HCPs. We need to not only start listening more but also start being more active in driving the change needed to do this. Only then will we start to see an industry that is truly respecting its customers and meeting their needs.

This week I had the immense pleasure of attending SMI’s Social Media in the Pharmaceutical Industry conference. As always I enjoyed the event, catching up with many of the #hcsmeu twitterati and hearing insights from the industry and patients.

The event started for me on Tuesday as I led a workshop looking at how pharma can successfully engage using social media (you can find my presentation here). With a small group we discussed some of the common issues that we still face in this space, for example internal barriers, lack of adequate process and poor understanding of this channel.

Most of these issues have been around for many years now and it does sadden me that they still need to be addressed in so many pharmacos. On the other hand it is great to be able to have a much richer and deeper set of case studies to use in the battle in bringing some of these barriers down. “We can’t because of regulations” clearly no longer cuts it – regulations have been clearly shown to not be a barrier. Another element that appears to still be an issue, and which saddens me greatly, is the view that social media does not need to be approached strategically. Whilst I am a huge advocate of pharma companies getting involved in social media I do not condone or recommend doing social media for the sake of it. There does need to be a clear strategy and plan – otherwise you are just taking pot shots in the dark – and frankly doing any form of business, marketing or communication without a strategy is just plain old bad business.

I was very happy however to see on Day 1 of the conference Stine Sorensen from Lundbeck discussing strategy, and not only its importance but the importance of having a regularly updated strategy (in this case she updates it every 6 months). I was also very happy to hear Stine mention that she now has the review & approval time for social media content down to 25minutes. I have had quite a few clients tell me that 24 hour approval times are unrealisitic so it is great to be able to counter this with the fact that quite a few companies now have process in place for near-to-live response. Not being able to respond very rapidly due to inappropriate review & approval process should no longer be a barrier (and mini self plug – I can help you work this out). In fact Stine supported everything I always say – there is no longer any room for excuses around not doing social media. Those days are gone and, as her slides so beautifully shows, excuses are useless!

Another great presentation was given by my friend Jackie Cuyvers, who recently left ZS to set up her own social listening company. Jackie is an extremely experienced social listener and she now specialises in doing global / local listening. Besides flagging the importance of asking the right, business questions, she talked us through some of the implications of social listening, in particular some of the linguistic and cultural elements that we tend not to think about. She mentioned how even in the same language there are big differences across countries and groups in use of terminology. In the UK for example “pants” means something quite different from “pants” in the US (underwear versus trousers) or the term “good crack” which means different things in the US and Ireland. She also made the point that just translating content directly often totally overlooks cultural nuances and local idiosyncrasies. In English for example we use the term “kick the bucket” but in Slovenia the translation of this term would be “whispering with crabs”. This has potentially huge implications on companies running social listening research, especially if they are dependend on pure technology or English language researchers. I also loved the fact that Jackie got an image of a dog into the conference – tres social!

Jackie’s summary of the 3 steps to social listening

One emphasis that came through throughout the conference though was the importance of patients and the incredible role they play, and the huge value that social media brings to them. The event was actually kicked off by three fabulous ladies, Birgit Bauer, Silja Chouquet and Marlo Donato Love who shared some great insights from a patient’s perspective and mentioned one of my favourite quotes “patients are the most underutilised resource in the pharmaceutical industry”. They talked about the importance of getting patients involved and the role they can play in working with pharma. Silja then also went on to talk about patients participating and “attending” medical conference virtually via social media. In fact she raised the point that whilst doctor’s are the main participants online at conferences patients are also increasingly getting involved as they search for more information on their conditions. She also made some great points about the futility of pharma’s current approach to using promoted tweets and how this is potentially going to be a big issue resulting in dilution of high value content on Twitter.

Perhaps a highlight for me though was Trevor Fossey who talked us through the impact of digital on patients and the NHS. I was nearly crying as he told us that he has access to his NHS medical record online, and that of this wife for whom he cares, and that as of 1st April every NHS patient has a right to access their medical record online. OMG! As a UK patient, with a chronic autoimmune disease, not having access to my medical records has been a big issue. I have been to numerous doctors, privately in the UK and abroad, and have never been able to show them my NHS blood results as I did not have access to them. Of course the fact that I now live abroad and don’t have a GP means in all liklihood I still won’t be able to access them but the realisation of what this means for other UK patients, including my elderly parents, was profound. Trevor mentioned some fantastic points about how impactful empowered patients really are – and how much money they save the NHS. I can tell you I was certainly not the only person in the room blown away but Trevor’s presentation – despite being a room full of digitally savvy people none of us where aware of our right to access our medical records online. Trevor found himself a whole group of advocates at the event (I for one have alreay shared to news to all my UK friends and family).

There were so many other great presentations, such as Letizia Affinito who showed us some great non-pharma case studies, and Pinal Patel from BMS who showed us how they are using social media in clinical trials – and more importantly how they are listening to patients and adapting their process in response to patient feedback. An awesome point was made that often once a trial is over patients are just left alone – but really we should be thanking them and sharing the results with them (something BMS plans to do now thanks to feedback). Charlotte Roth from Actelion also gave the Corporate POV around social media, bringing an additional dimension to the conference, while Liz Skrbkova shared perspectives around multi-channel engagement and online influencers. I also have to add that IMHO Liz was one of the best dressed ladies at the event 🙂

Last but not least was the pleasure of meeting all these amazing people and having some great discussions, including over wine and dinner. Dinner also gave me the opportunity to catch up with a couple more of the #hcsmeu and the next day I was able to sample some of the most amazing cocktails at the Alchemist in the evening. Afterall what would a social media conference be if it didn’t include the “social” bit!

Despite my grumbles of not having had time to post much to this blog I have managed to find time to write three blog posts for the ZS Associates blog The Active Ingredient. The subject of this triad of posts engaging with KOL and KOI online, starting with why it is important, how to engage online with KOL and with KOI. I actually wrote about this over a year ago and to date it is probably the blog post I have shared the most with pharma clients and teams.

It is a subject area I am passionate about and as you can read in the posts it has potentially a huge value for pharma companies. The relationships of today are increasingly happening online as well as offline and the sheer volume of content on the internet is making it harder to find relevant information. Content shared by KOI is more likely to be found, in part because of their networks, but also because people are more likely to read something shared by a KOI rather than by a pharma company. Building those online relationships today is therefore aligned with current trends but also helps companies make the most of those increasingly tight budgets by expanding the reach of their content.

I was already looking at this over three years ago, and given this potential value I really thought that pharma was going to start doing more in terms of engaging online with KOI and KOL. However to date very few are doing this, with exceptions like Roche Diagnostics & diabetes bloggers and some of the early steps being taken by Boehringer Ingelheim.

Screenshot from Little Bird tool

Whilst a few years ago it would have taken a great deal more manual effort to identify these KOI today there are some great tools out there to do this. I actually spoke this afternoon to Little Bird who took me through their tool. I loved it! It does exactly what one needs to identify the KOI and has some great ways of looking at the data and provides actionable insights. Of course it is just a tool and the key to any tool is how you use it. When looking at this particular area the key thing is to focus on the relationship part. Once you have identified the KOI you need to develop a clear plan of who exactly you will build a relationship with, why and how. This is something that cannot be automated and is not something that should be left to your agencies! Just as in the offline world to build the relationship you actually have to present, the same is true online. How can you build a relationship through a 3rd party, or even worse through a barrage of automated tweets?! And do you really want your agency to own these strategic relationships?

Whilst in the pass the tools were a barrier to building online relationships, today I believe the key barrier for pharma companies is the lack of internal knowledge and process to deal with this new relationship model. This however should not be a barrier anymore. Equipped with the insights and looking at how relationships work offline companies can start to put in place the expertise and process required to build these relationships. Perhaps the main question is not how can they do this but why on earth are they not started doing this already?

The term “patient centric” seems to be cropping up more and more but is it just another buzzword, like Multi-Channel Marketing was last year? And what exactly does “patient centric” mean?

Looking first at the meaning of “patient centric” – it essentially is what it says! It is about putting the patient at the center. Sounds simple – especially if you do not work in the pharmaceutical industry. In most industries it is a no-brainer that you center your marketing, strategy and indeed whole business, around the end user of your product and service. After all if your customers are not happy with your product or service you will potentially go out of business. In healthcare, and in particular from the pharmaceutical industry perspective, things are not quite so simple.

To start with the industry still sees physicians as their customer, not the patients. This is in part as a result of regulations but also in part historical. Until recently patients had little say or voice in their healthcare and relied almost entirely on healthcare providers for information and, to an extent, decision making. This, coupled with regulations forbidding most direct contact between industry and patients in most countries, meant that the patient rarely came into the equation. As far as the industry was concerned the key decision maker, and therefore customer, was the physician. Now as to how customer centric the industry is towards these customers is another story – and warrants a separate blog piece!

The advent of the internet and social media has led to a change in the dynamics between patients and their healthcare. Increasingly physicians are not the only, or indeed in some cases the main, source of information. Increasingly it is other patients who provide the answers and the information. And increasingly other sources online provide information to patients – not always accurate or appropriate but there none-the-less.

A recent example I saw was of a diabetes patient who reached out to a closed group of online friends. She had recently been prescribed a product by her physician but as a result of some of the things she had read online around side effects she was very scared of starting the treatment, despite her physician’s advice. She was delaying starting the treatment out of fear, which her physician had not allayed (and indeed had probably not covered in the brief appointment). She therefore turned to this Facebook group to express her concerns – not so much asking for advice as just wishing to share her feelings. Fortunately for her a couple of people in the group had experience with this product and told her not to be afraid and that it really was not that bad. They provided her with the more accurate, personal information she required but they also calmed her fears and provided the emotional support she needed. As a result of this she started her prescription as her physician instructed.

So how does this story help a pharma company looking to be more customer centric? Outside of the US the first response would probably be “oh we can’t talk about our products with patients so we are powerless in this situation”. Poppycock I say to that! Whilst in Europe companies are severely restricted in what they can communicate directly to patients they are able to communicate directly to physicians. In the example above had the physician been more aware of the conversations that his patients are reading online he may have been better prepared to allay his patient’s fears. Some appropriate patient support materials speaking to these fears may also have been useful for the physician to share. In the US the same rings true but there is the added element that pharma marketeers need to be aware of the dangers of DTC advertising. Due to regulations they have to document the long list of possible adverse events – which to many patients is far more scary than the disease! Again being aware of how patients feel, are communicating and thinking, can help counter some of this – for example by moving away from being so promotional to being more supportive in the messaging.

In essence being patient centric is about bringing some of this customer centric thinking into the work practice. It involves making sure you really understand your patients. How are they using your products? What are their fears and concerns? What support do they need? What issues do they have taking your products compliantly? How do you use this information in your daily work? This is even easier to do today – just as patients have access to more information so do companies. Using social media listening for example companies can identify what the key pain points are and look to provide support accordingly (either directly or via physicians).

This brings me back to my first point – is this really happening or is “patient centric” just another buzz word? Judging by pharma companies websites it is real – many of them promote their patient focus on their homepages suggesting that this is indeed of strategic importance. Sadly digging a little deeper shows that in many cases this is indeed just another buzz word. In many pharmaceutical companies there is talk of being more patient centric but too little action to support this talk. The regulatory burden puts many off. The lack of innovative thinking hampers others. But perhaps the biggest issue is the lack of realisation of just how import patient centricity really is. Whilst the example above is of just one patient – mulitply this by thousands and you start to see an impact on revenues. With patent cliffs, more specialised pipelines and tightening budgets every patient starts to count. What good is it convincing doctors to prescribe your products if the patients are getting information online that then dissuades them from using the product?

Patient centricity must move beyond being a buzzword for the industry. It needs to be embraced and incorporated fully by the industry today. Without patients there would be no industry so it is time the industry started acknowledging patients and taking their needs, but also their potential power, more seriously. Because if not who knows what the future holds for the industry – but I doubt it will be that profitable.

The world as we know it is changing. Our stakeholder’s way of thinking, and behaving, is changing due to 24/7 access to global information. So how does this impact our industry and what are the opportunities for pharma marketers?

Patients are engaging online around their health, and they expect to be able to engage online with other people and companies in this space. They do not understand why big pharma companies does not engage and this exacerbates the industry’s poor reputation. From a corporate marketing point of view this is an easy win. By accepting social media, rather than avoiding it, companies can start to have a positive impact on their reputation, and build corporate brand value.

This new dynamic is also impacting physicians, who face patients coming to appointments well informed, and with different questions than they used to, for example “is there an app for that”. Here again is a nice win for marketers. Rather than focusing on providing the information that they want physicians to hear, i.e. all about their product, why not look at also providing value by helping physicians with some of these real-world issues? Why not sponsor an assessment of disease apps, or ensure that the physician is kept up to date with what patients are Googling?

Another impact that the digital environment has led to is an increased pressure on people’s time. Marketing now means that you are no longer just competing with another pharma company. You now compete with a whole array of different parties to get a slice of a physician’s time. Give a person the choice to access information when they want and how they want, or to physically sit through a sales call at a specified time and it is a no-brainer which option people will increasingly choose. That is not to say that people will stop choosing the physical meeting altogether but they want a mix of options – and a choice.

Here again that word “value” comes in. As a marketer the way to grab a piece of someone’s time is to deliver value, both in terms of channel preference but also in terms of content. Digital enables us to understand individual’s areas of interest – why not then deliver your marketing information tailored to their preferences?

Of course this costs money, which is an age old problem. Again digital can help. Traditionally pharma marketing has been very siloed, by brand, function and geography. Digital provides the means to break down these siloes and generate cost efficiencies. By working in a more collaborative way, digitally facilitated, companies can reduce waste, for example in asset development and in time. Why should each brand, in each country, produce their own app? Often they have a similar end use and the backbone could be developed jointly and then adapted for local end use.

And this brings me onto the final massive change that digital, and in particular social media, has led to – namely access to information. The amount of information available on our stakeholders online is huge. Despite this I still see teams basing the bulk of their marketing plans on traditional market research with very little social media listening included. Now social media listening is not the be-all-end-all but it should be included. It provides key insights that need to be part of a modern marketing plan, for example where do your customers go for information, what topics are they talking about (and here is a hint – it is probably not about you) and what are their needs. Social media enables pharma marketers to get a better understanding of stakeholder’s emotions and behaviours, and at the end of the day it is emotions and behaviours that impact pharma sales.

Digital is no longer new and it is an integral part of daily life. Companies today should be optimising their marketing to reflect this digital impact and to start offering their stakeholder’s real value.

One of the great things about a new job is meeting loads of new people and having some really great introduction conversations. In my case of course the conversation invariably, at some point, turns to my digital expertise. I have always been wary to call myself a digital expert – it is such a huge field and it is constantly evolving so it is very hard to be a genuine expert in this field. There are also so many new apps and “shiny toys” that I myself have not personally used and again I find it slightly false to be talking about something if you have no experience in using it yourself.

It is precisely because of this that I decided to have a go at using Vine. I have heard so much about it but have had remarkably limited exposure to it. I had asked myself a number of questions around its use, such as what the point of it was and whether it is a social media channel or an app? I presumed it would be just like the other apps – and I was not sure I would think much of it.

The result however is that I have had an evening of fun trying to catch snippets of my cats doing silly things! Awesome fun – and as we know cats are the foundation of Maslow’s internet hierachy of needs so purfect! And then once I started sharing these snippets of Don and Ninja (my cats) on Don’s Facebook page (yes my cat has a Facebook page) and the comments started streaming in, it all fell into place for me. Vine was clearly made for cat videos and therefore is an integral part of social media!

On a more serious note though one thing that Vine very nicely demonstrates is the ease with which individuals can create their own content, without specific skills, and using a simple app and a smart phone. Apps like Vine and Instagram have given each and every one of us the power to create dyanmic audiovisual content which we can share. This is a great power but it is also a great opportunity for budget strapped companies. People like to create their own content and they like to share. Companies always need more content. This seems like a match made in heaven. In theory it should be, and each year, as more and more apps like Vine and Instagram are introduced, this opportunity will grow.

The reality is however that many companies who are starting to dabble in social media are not only scared of allowing customers to provide their own content but also thoroughly underestimate the amount of content they will need. This double whammy results in few companies seriously looking into, and planning for, customer content creation. Some companies have dabbled in this with the odd Pinterest board, but very few have fully embraced customer participation and contribution as an integral part of their social media strategy. Will this change? I think it will have to. Budgets will remain tight so seeking out new content sources will only grow in importance. Meanwhile the opportunity to engage with customers and get them to contribute to content will grow and it will become more and more obvious that this is an opportunity that companies need to seize with both hands.

Does this mean that pharma companies social media initiatives will suddenly become full of Vine videos of cats? Probably not! But it does mean that if pharma companies take on board the gift that apps like Vine and Instagram are offereing they will make better use of their budgets, start having social media initiatives with sufficient new content, and be a step closer to building those much touted online relationships.

As I mentioned in my previous post most Pharma companies have a great idea of who their offline, traditional KOLs are but very little idea of who the Key Online Influencers (KOI) are. They also rarely have any real idea of how many of their offline KOL are active online and using social media. Pharmaceutical companies should have a far better understanding of the online activity of all their key stakeholders, including KOI but also KOL.

The reality is that most top KOL, who tend to be older, are not that active on social media, but they also would see little value in spending their time with social media. They are extremely busy and have already reached the top of their game – for them social media may be a waste of time.

Younger, up and coming KOL however are another matter. Whilst they may not be digital natives they are more adept at using digital resources and some may also already be using social media. This group is also trying to reach the top and expand their name within their field and the healthcare industry. To this group, social media can be a valuable tool, enabling them to extend their reach and influence, and giving them a leg-up to top tier KOL status.

This is a huge opportunity for pharma. KOL have always played a key role within the industry and building relationships with KOL is standard practice. One of the core elements to relationships of this nature is being able to bring value. Helping up and coming KOL building their “brand” online and helping them turn themselves into KOI could be a hugely valuable resource that pharma could offer this group.

So could a pharma company go about working with up and coming KOL around their use of social media? Absolutely! The first thing to do, as with all initiatives, is to do some research. Identify who the up and coming KOLs are (the chances are this has already been done by Medical) and then find out if they are active online, and if so how and where. Also find out whether their name already has digital klout, even if they are not themselves online.

The next step is then to reach out to them and find out if they would be interested in social media training. The key element here is to communicate the value to them and ensure they understand that this would be a totally neutral training, with no expectations of them to start tweeting information about the company.

At this point I often get asked about how to set this up internally, process-wise. The reality is that this process generally already exists. Companies often do media training with KOL and social media is a form of media so the same process, with a few amendments, could be used. It should be relatively simple to offer KOL social media training, either as part of their media training, or as a stand alone training. In fact given time pressures, and some potential reticence on the part of the KOL to participate, it is probably more effective to do a quick intro to social media as part of the media training, and then offer an additional social media specific training as a follow on. This initial session can be used to demonstrate the value of social media to the KOL personally. A follow up session can then delve into more details and provide more hands on practice.

The final element to remember is to be realistic regarding timing and ROI. Do not expect every KOL trained to become a KOI – start with conservative KPIs (for example 1 in 10 trained per year will become active on social media). Also remember to be realistic with timing – becoming active on social media does not happen overnight – allow at least one year for the KOL to fully master social media and to start seeing some impact from the training.

This training could however have a great positive impact, for the KOL, the pharma company but also for other stakeholders such a patients. As the KOL becomes more fluent and adept at using social media they will move towards becoming a KOI, ensuring good quality information becomes prominent in their field. From the pharma company’s point of view if the digital information they produce and share is of good quality and of value to the KOL, and their followers, the result will be more impactful digital assets with a greater reach.

Finally of course is the fact that this whole process can act as a great way to build, and strengthen, the relationship with that up and coming KOL, so that when they do reach the top the company has played a pivotal role in supporting them and being there, as a partner. And of course let us not forget that eventually all KOL will be KOI anyway, it is just a matter of time – this opportunity exists now but will not exist in a few years time!

Thank you to KOL / KOI Dr James Underberg aka @Lipiddoc for his insights into this post.

Last week I was at the GLC social media & emarketing forum in Frankfurt listening to an interesting presentation by about HCP relationships. One of the slides presented showed a KOL map, showing who the KOLs are, who the upcoming KOLs are, and where they are based. This map is developed based on an analysis of presentations at congress and publication – but it is all offline inputs. I am however happy to hear that they are also looking into doing a KOL digital map.

Personally this rings a bell a with me as one of my recommendations in the past has been to do precisely this. Pharma companies generally have a great idea of who their traditional KOLs are, but they have no idea about how active they are online (if at all) and they often have no real idea of who KOI (Key Online Influencers) are. This is a big gap in a key knowledge area. As more and more HCPs turn to digital the impact of KOI will become increasingly important. Pharma companies need to start finding out which KOL are active online, and who the KOI are that they should be building relationships with them, just as they have traditionally built relationships with KOLs. This is essentially just a new group of KOL and the process for KOL relationship development offline already exist – they just need to be adapted for online.

From experience I know however that at this point alarm bells go off with legal and compliance as this is a new area. A second issue though is that unlike KOLs who are always HCP KOI may be HCPs, but they may also be journalists, bloggers, patient advocates, etc. This raises a whole area of problems. For the HCP KOI it is relatively simple to deal with – they fit into the existing framework and the Medical teams can build the relationships here, using a different process but still essentially following the same principles and guidelines. The problem however is how to deal with the other KOI – who owns the relationship? How to deal with the various regulatory issues that then arise? So, for example, for a non-HCP KOI there is the danger of being seen to be doing promotion. How can a pharma company deal with these issues?

The answer is to be totally transparent and never, ever look at relationship building from a promotional point of view. Building relationships needs to be based on providing value, whether it be for an HCP or a patient KOI. With that thinking as a starting point you then do some research. What are the KOI interested in? What content and assets would be of value to them? Do they have a blogger outreach policy or do they give any indication of how they feel about partnering with organisations? Build up a good level of knowledge about each individual KOI, just as one would do with a traditional KOL.

You then need to identify where the relationship will sit. As mentioned Medical KOI relationships sit comfortably with medical, journalists sit well with the comms team, and patient advocates sit well with advocacy teams. Very rarely do these relationships sit in marketing – even though very often this is where the desire to have these relationships starts. The other issue is of course also that digital and social media often sits either with marketing or comms – not with Medical, and yet Medical is the area that could really provide the most value and also get some real benefits from social media. Given the lack of digital expertise in Medical there is a strong argument, in some cases, for some relationships to live with the digital or social media team, who (hopefully) understand the dynamics of digital relationships.

Once you have identified who owns the relationship you then need to start relationship building. Like any relationship it will depend on the individuals involved, what channels they use, what value you can provide etc. However in general your first step will be to start building the relationship digitally – retweet their content, comment on their blog posts, etc. Offline however also plays a pivotal role in this relationship building – just because this is a digitally focused relationship does not mean it has to only stay in the digital arena. If you know the KOI is going to be attending the same conference as you then get in touch and arrange a meeting. Or perhaps you see that the KOI is going to be in the same town as you – arrange to meet for a coffee. Alternatively invite them to a specific event you are organising.

A good example of this comes from Roche Diagnostics blogger summits which are annual events they organise with key diabetes bloggers specifically to build relationships. Roche has been very successful – partly because they were realistic in their approach and accepted that this would need to be a long term initiative and it would take time for the summits and relationships to work (in fact it took 3 years). Another reason Roche was so successful was also because they went in with a “what can we do for you” mentality – rather than a promotional “what can you do for me mentality” – they asked attendees what they needed from the organisation and what value Roche could bring to the community. The response Roche got was very positive and they now have a good relationship with the community, who blog and tweet about Roche’s initiatives and help improve the Roche name within the community.

Follow Roche’s lead then when you look at building your own KOI relationships – allow time, and focus on their needs first and not your own. As the relationship develops and builds it will turn into a win win relationship, with the KOI spreading the reach of your content and providing a more credible way of reaching your target audience. Put aside internal squabbling and politics to focus on the relationship and share knowledge and process internally. Building KOI relationships will increasingly become a key part of the “KOL” process in the future so learn how to do it today – and do it well.

I have been asked to talk about the topic of “Is Pharma Afraid of Social Media” at the GLC Social Media and Emarketing Forum this week in Frankfurt. Had I been asked this question a few years ago, indeed even last year, I would have said a resounding “Yes”. However times have changed and my initial response to this was “not anymore”. But I thought I would reach out and ask the community and see what they thought. I posted a poll on Linkedin, and then shared it via Linkedin and Twitter.

The second surprise was that I thought the majority of answers would go to “Yes and No” as opposed to “Yes” or “No” – if anything because it is the most neutral “depends”-like answer. The result so far however is a resounding “Yes” with over 50% voting that Pharma is indeed afraid of social media.

Personally my response is the “Yes and No” because of the mix in responses to social media – there have been some great examples but there are also a large number of pharma companies failing to adequately engage via social media. I can however understand the strong tendency towards the “Yes” vote – there are certainly enough examples of pharma being scared of social media.

Firstly, while there are many pharma companies that have undertaken great social media initiatives (like GE Healthcare’s current #GetFit initiative) there are far more examples of no initiatives or a lack of activity. If we look at Facebook for example at first glance it looks like pharma is finally onboard as most of the big companies have some sort of Facebook presence. On closer inspection however you will notice that very few have their walls open to posting – Boehringer Ingelheim is one of the few to do this. This shows, in my opinion, a fear of opening up to conversation, questions and engagement. By restricting your engagement simply to comments under your own posts you have some form of control – comments are less visible than posts and in theory will be focused around what you posted. This reflects pharma’s fear of giving up control – something which is a reality on social media.

Boehringer Ingelheim and Novartis’s Facebook pages

Secondly is the age old regulatory argument. As Andrew so rightly points out there are very few examples of regulatory bodies raising complaints or having issues with any of pharmas social media activity (including Boehringer Ingelheim’s full-on engagement approach). Nonetheless this fact seems to have evaded a number of people in pharma. Regulatory constraints is still the number one push back I get from pharma companies around why they are not active on social media. It is a great, and very comfortable excuse. It also highlights the fear of trying something “new” (even if social media really is no longer new).

Thirdly I believe politics and internal inefficiency is often holding companies back from publishing and pushing through social media guidelines. Yes many companies have these (I like Andrew have also written quite a few!) but what I have also seen is that these guidelines get approved and may get shared with a few people at global and department level, but it is not unheard of to find out that people on the ground, at local level, have no idea that these guidelines exist, or if they do they are still to concerned to take the risk to implement. For guidelines to be effective they have to be communicated, publicised and encouraged, from senior executives, otherwise they end up in drawers or getting ignored.

Finally I think the sad reality is there is still a great deal of “ostrich head in sand” syndrome in the industry – the concept that if I do not see or hear it then it does not exist or affect me. I have often heard the reason / excuse for not doing social media that “it is not relevant to me / to my stakeholders”. My response to that is “take your head out of the sand and look around”! There are very few instances when there is literally no value or use in social media. Certainly all marketing and communications related departments, and those relating to clinical trials, can glean a great deal of insights just from social media listening. As to stakeholders not using social media – this is an ever diminishing group – do they really warrant your total lack of attention in this area?

So there is still a great deal of fear of social media in pharma. That said I am an optimist and I think that fear is diminishing. I firmly believe if I redo this survey next year there will be a resounding majority answering “No” pharma is not afraid of social media.